Functional Muscle Power Testing in Young, Middle-Aged, and Community-Dwelling Nonfrail and Prefrail Older Adults

doi:10.1016/j.apmr.2010.12.031

Archives of Physical Medicine and Rehabilitation

Volume 92, Issue 6, June 2011, Pages 967-971

https://doi.org/10.1016/j.apmr.2010.12.031 Get rights and content

Abstract

Zech A, Steib S, Freiberger E, Pfeifer K. Functional muscle power testing in young, middle-aged, and community-dwelling nonfrail and prefrail older adults.

Objective

To evaluate the stair climb (SC) and sit-to-stand (STS) transfer test for functional power assessment in young, middle-aged, and community-dwelling nonfrail and prefrail older adults.

Design

Cross-sectional study.

Setting

Sport science institute providing health-related exercise programs for older people.

Participants

Participants (N=60; age, 22–81y) were divided into groups of young (n=15; 20–30y), middle-aged (n=16; 40–60y), nonfrail older (n=16; >65y), and prefrail older adults (n=13; >65y).

Interventions

Not applicable.

Main Outcome Measures

SC and STS transfer power were measured on 2 separate occasions.

Results

Age and height correlated positively (P<.001) with both power measures. Multiple linear regression analysis showed that 67.9% (R²) of the variance in SC power and 31.3% (R²) of the variance in STS transfer power can be attributed to age and height. Significant age-related subgroup differences were found for SC power (P=.001). Nonfrail and prefrail older adults differed significantly in both power measures (P<.001).

Conclusions

The findings indicate that SC and STS transfer power are sensitive enough to distinguish between nonfrailty and prefrailty. This suggests that both tests are relevant clinical measures in older people.

Section snippets

Methods

Ostensibly healthy people (N=60; height, 170.5±8.4cm; body mass, 72.8±10.9; BMI, 25.1±4.0kg/m²; age, 22–81y; mean ± SD, 55.7±21.7y) gave written informed consent to participate in this study after the procedures had been fully explained. Young (n=15; 20–30y) and middle-aged adults (n=16; 40–60y) were recruited from students and staff of our institution by using informational fliers distributed within the institute inviting students, office and technical workers, and lecturers to participate.

Results

All participants were able to complete the power tests without assistance. There were 2 failed SC attempts (1 nonfrail and 1 prefrail older adult) due to balance loss. In 6 cases, subjects (2 nonfrail and 4 prefrail older adults) did not immediately reach an upright standing position during STS transfer. These data were excluded from analysis and the trials were repeated.

Participant characteristics and power data are listed in table 1. Pearson correlation between subject characteristics and

Discussion

In this study, the SC and STS transfer power tests were evaluated in young, middle-aged, and community-dwelling nonfrail and prefrail older adults. A significant association was found between functional lower-limb power and participant characteristics. Age had the strongest association with both power measures, followed by body height. Multiple linear regression analysis suggests that almost 70% (R²) of SC power and approximately 30% (R²) of STS power can be predicted by age and height,

Conclusions

Results of the study showed that increasing adult age was associated with a decrease in SC and STS power. Almost 70% of SC power and approximately 30% of STS power can be predicted by age and height. These findings were supported by significant differences in SC power among subgroups of young, middle-aged, and older adults. Because of low statistical power, the absence of significant age-related subgroup differences in STS power should be viewed with caution. Nevertheless, results indicate that

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Which trunk muscle parameter is the best predictor for physical function in older adults?
2023, Heliyon
Despite preliminary evidence demonstrating the relevance of trunk muscle strength for physical function in older adults, it is not clear which muscle-related trunk parameter is the best predictor for physical functions. Therefore, this study aimed to compare trunk muscle morphology or strength parameters regarding their predictive ability for physical functions.
Seventy-four older adults (38 men, 36 women, mean age 76.85 years) were tested for maximum absolute and relative isokinetic trunk flexion and extension strength, trunk lean mass, and trunk muscle quality. Functional assessment included normal and fast walking speed, repeated sit-to-stand transfer, timed up and go, and postural sway during a closed-feet and a semi-tandem stance adjusted for body height. Pearson's correlations were used to compare relationship between trunk strength adjusted and unadjusted for body weight to physical functions. Linear regression analysis including sex and age as co-variables was performed between trunk muscle and functional test parameters.
Relative back extension strength was the most consistent significant predictor for all physical function tests (p = 0.004–0.04) except for postural sway. Relative trunk flexion strength was related to normal walking speed (p = 0.024). Trunk lean mass was related to timed up and go performance (p = 0.024).
Relative back extension strength is associated with better performance in nearly all standard tests for physical function in older adults, while trunk flexion strength and lean mass seem to play a minor role. Our findings emphasize the importance of trunk muscle strength, especially the back extensor muscles, for physical function in older adults.
Assessment of functional sit-to-stand muscle power: Cross-sectional trajectories across the lifespan
2021, Experimental Gerontology
Citation Excerpt :
Also representing a main study finding, the relative (percentage) decline rate in STS muscle power was generally found to increase with age. Though literature on the subject is sparse, changes in STS muscle power with age has been studied using linear position transducer methodology (Glenn et al., 2017) and force platform analysis (Dietzel et al., 2013; Roberts et al., 2018; Zech et al., 2011). Absolute and relative STS power have previously been reported to decline with age (Dietzel et al., 2013; Glenn et al., 2017; Roberts et al., 2018), although with some differences regarding the age interval at which decreased STS power measures are detected.
The 30-s sit-to-stand (STS) muscle power test is a valid test to assess muscle power in older people; however, whether it may be used to assess trajectories of lower-limb muscle power through the adult lifespan is not known. This study evaluated the pattern and time course of variations in relative, allometric and specific STS muscle power throughout the lifespan.
Subjects participating in the Copenhagen Sarcopenia Study (729 women and 576 men; aged 20 to 93 years) were included. Lower-limb muscle power was assessed with the 30-s version of the STS muscle power test. Allometric, relative and specific STS power were calculated as absolute STS power normalized to height squared, body mass and leg lean mass as assessed by DXA, respectively.
Relative STS muscle power tended to increase in women (0.08 ± 0.05 W·kg⁻¹·yr⁻¹; p = 0.082) and increased in men (0.14 ± 0.07 W·kg⁻¹·yr⁻¹; p = 0.046) between 20 and 30 years, followed by a slow decline (−0.05 ± 0.05 W·kg⁻¹·yr⁻¹ and −0.06 ± 0.08 W·kg⁻¹·yr⁻¹, respectively; both p > 0.05) between 30 and 50 years. Then, relative STS power declined at an accelerated rate up to oldest age in men (−0.09 ± 0.02 W·kg⁻¹·yr⁻¹) and in women until the age of 75 (−0.09 ± 0.01 W·kg⁻¹·yr⁻¹) (both p < 0.001). A lower rate of decline was observed in women aged 75 and older (−0.04 ± 0.02 W·kg⁻¹·yr⁻¹; p = 0.039). Similar age-related patterns were noted for allometric and specific STS power.
The STS muscle power test appears to provide a feasible and inexpensive tool to monitor cross-sectional trajectories of muscle power throughout the lifespan.
Effects of shelf bar assistance on kinetic control during sit-to-stand in healthy young and elderly subjects
2020, Journal of Biomechanics
Citation Excerpt :
Riley demonstrated that the magnitude of the linear momentum of whole body in the vertical and forward directions and vertical ground reaction force (GRF) during successful STS were higher than those during failed STS in healthy elderly people (Riley et al., 1997). In fact, in elderly fallers, the lower limb muscle power, calculated using the production of velocity of CoM and GRF in the vertical direction during STS, decreased (Fleming et al., 1991; Lindemann et al., 2003; Zech et al., 2011; Cheng et al., 2014; Kato et al.,2015; Álvarez Barbosa et al., 2016; Alcazar et al., 2018; Vincenzo et al., 2018). Consequently, in elderly subjects, there will be a greater demand for devices that provide assistance during successful STS.
This study aimed to determine the kinetic effects of using unilateral shelf bar, vertical grab bar (GB), and horizontal GB during sit-to-stand (STS) in young and elderly subjects. Twenty young adults aged 20–40 years and eighteen healthy elderly people aged ≥ 65 years old were recruited. The subjects performed STS with and without using the three types of bars. Bar reaction force (BRF) and maximum power (MP) defined as the maximal product calculated by multiplying the GRF and the velocity of the center of mass in each direction were measured using three-dimensional motion analysis, two load sensors of GB, and four force plates. The use of the shelf bar generated a significantly larger BRF in the vertical direction than the other bars (p < 0.05) and lower MP in the vertical direction than the horizontal bar (p < 0.05) and no bar (p < 0.05). In the younger subjects, only the use of the vertical bar generated a significantly larger BRF (p < 0.05) and negative MP (p < 0.05) in the forward direction than those in elderly subjects. The use of the shelf bar may assist the decreased MP in the vertical direction during STS in elderly people, resulting in decrease of failed STS in daily living. In contrast, the use of the vertical bar in the elderly may not generate sufficient BRF in the forward direction because of lack of eccentric control in the whole body in the forward direction during STS.
The sit-to-stand muscle power test: An easy, inexpensive and portable procedure to assess muscle power in older people
2018, Experimental Gerontology
Citation Excerpt :
The sit-to-stand (STS) test (Csuka and McCarty, 1985) is an easy, rapid, and commonly used functional performance measure that involves measuring the time taken to stand from a seated position a certain number of times or recording the number of repetitions undertaken in a given period, with low space, material and time requirements. In addition, several studies have evaluated STS muscle power by the utilization of a force platform (Alvarez Barbosa et al., 2016; Chen et al., 2012; Cheng et al., 2014; Drey et al., 2012; Fleming et al., 1991; Lacroix et al., 2015; Lindemann et al., 2003; Lindemann et al., 2007; Regterschot et al., 2016; Zech et al., 2012; Zech et al., 2011), a linear position transducer (Alvarez Barbosa et al., 2016; Glenn et al., 2015; Glenn et al., 2017a; Glenn et al., 2017b; Glenn et al., 2016; Gray et al., 2016; Gray and Paulson, 2014; Kato et al., 2015) or a 3D accelerometer (Regterschot et al., 2016; Zijlstra et al., 2010). However, these procedures present the economic and technical limitations mentioned above for their applicability in large studies or in the clinical setting.
Skeletal muscle power has been demonstrated to be a stronger predictor of functional limitations than any other physical capability. However, no validated alternatives exist to the usually expensive instruments and/or time-consuming methods to evaluate muscle power in older populations. Our aim was to validate an easily applicable procedure to assess muscle power in large cohort studies and the clinical setting and to assess its association with other age-related outcomes.
Forty community dwelling older adults (70–87 years) and 1804 older subjects (67–101 years) participating in the Toledo Study for Healthy Aging were included in this investigation. Sit-to-stand (STS) velocity and muscle power were calculated using the subject's body mass and height, chair height and the time needed to complete five STS repetitions, and compared with those obtained in the leg press exercise using a linear position transducer. In addition, STS performance, physical (gait speed) and cognitive function, sarcopenia (skeletal muscle index (SMI)) and health-related quality of life (HRQoL) were recorded to assess the association with the STS muscle power values.
No significant differences were found between STS velocity and power values and those obtained from the leg press force-velocity measurements (mean difference ± 95% CI = 0.02 ± 0.05 m·s⁻¹ and 6.9 ± 29.8 W, respectively) (both p > 0.05). STS muscle power was strongly associated with maximal muscle power registered in the leg press exercise (r = 0.72; p < 0.001). In addition, cognitive function and SMI, and physical function, were better associated with absolute and relative STS muscle power, respectively, than STS time values after adjusting by different covariates. In contrast, STS time was slightly more associated with HRQoL than STS muscle power measures.
The STS muscle power test proved to be a valid, and in general, a more clinically relevant tool to assess functional trajectory in older people compared to traditional STS time values. The low time, space and material requirements of the STS muscle power test, make this test an excellent choice for its application in large cohort studies and the clinical setting.
Accuracy and concurrent validity of a sensor-based analysis of sit-to-stand movements in older adults
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The STS performance of the older adults as measured with the force plates was comparable to the STS performance of older adults measured with force plates in other studies. The range of CoM peak powers (117.0–594.3 W) includes the mean CoM peak power as reported in other studies (439.5 ± 158.8 W [5], 457.37 ± 142.69 W [11] and 424 ± 161 W [16]). In addition, the range of STS durations measured with force plates (1.41–2.71 s) includes the mean STS duration as measured with force plates in another study (1.82 ± 0.51 s [11]).
Body-fixed motion sensors have been applied for the assessment of sit-to-stand (STS) performance. However, the accuracy and concurrent validity of sensor-based estimations of the body's center of mass (CoM) motion during STS are unclear. Therefore, this study investigated the accuracy and concurrent validity of sensor-based measures of CoM motion during STS in older adults. Accuracy and concurrent validity were investigated by comparing the sensor-based method to a force plate method. Twenty-seven older adults (20 females, 7 males; age: 72–94 years) performed five STS movements while data were collected with force plates and motion sensors on the hip and chest. Hip maximal acceleration provided an accurate estimation of the center of mass (CoM) maximal acceleration (limits of agreement (LOA) smaller than 5% of the CoM maximal acceleration; estimated and real CoM maximal acceleration did not differ (p = 0.823)). Other hip STS measures and the chest STS measures did not provide accurate estimations of CoM motion (LOA ranged from −155.6% to 333.3% of the CoM value; sensor-based measures overestimated CoM motion (range p: <0.001 to 0.01)). However, the hip sensor did not overestimate maximal jerk of the CoM (p = 0.679). Moderate to very strong associations were observed between sensor-based estimations and actual CoM motion (range r = 0.64–0.94, p < 0.001). Hence, sensor-based estimations of CoM motion during STS are possible, but accuracy is limited. The sensor-based method cannot replace laboratory methods for a mechanical analysis of CoM motion during STS but it may be a practical alternative for the clinical assessment of STS performance in older persons.
Validity of a video-analysis-based app to detect prefrailty or frailty plus sarcopenia syndromes in community-dwelling older adults: Diagnostic accuracy study
2024, Digital Health

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Original articleFunctional Muscle Power Testing in Young, Middle-Aged, and Community-Dwelling Nonfrail and Prefrail Older Adults

Abstract

Objective

Design

Setting

Participants

Interventions

Main Outcome Measures

Results

Conclusions

Section snippets

Methods

Results

Discussion

Conclusions

Arch Phys Med Rehabil

A new method for measuring power output in a single leg extension: feasibility, reliability and validity

Eur J Appl Physiol Occup Physiol

Age associated loss of power and strength in the upper extremities in women and men

J Gerontol A Biol Sci Med Sci

Lower extremity strength and power are associated with 400-meter walk time in older adults: the InCHIANTI study

J Gerontol A Biol Sci Med Sci

Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65

Age Aging

A comparison of leg power and leg strength within the InCHIANTI study: which influences mobility more?

J Gerontol A Biol Sci Med Sci

Quadriceps maximal power and optimal shortening velocity in 335 men aged 23-88 years

Eur J Appl Physiol

Original article
Functional Muscle Power Testing in Young, Middle-Aged, and Community-Dwelling Nonfrail and Prefrail Older Adults